Mobility GI issues

Hirschsprung disease

congenital aganglionic megacolon

4x common in males and downs syndrome

rectal biopsy is needed

s/s in newborns:

• bilious vomiting

• failed to pass meconium within 24 hrs

s/s in an infant

• enterocolitis

• fever diarrhea

s/s in childhood

• ribbon like stool

• foul smelling

• undernourished

• anemic appearance

Hirschsprung disease management

• may need temp colostomy

• enemas

• surgery (most likely)

pre op for Hirschsprung disease:

• empty bowel

• abdominal circumference

• NPO

post op for Hirschsprung disease

• restart feeds

• colonostomy care

assess bowel function and hydration

colonostomy care education

GERD

gastric contents move into esophagus

most common at night after a meal

complications if having GERD for 1 year

• respiratory problems

• dysphagia

s/s of GERD in infant

• spitting up

• irritability

• back arching

• gagging/choke with feeds

• feeding refusal

s/s of GERD in child

• heart burn

• abdominal pain

• chronic cough

• dysphagia

• recurrent vomiting

GERD diagnostic

• H&P

• 24hr intraesophageally pH monitoring not reliable

GERD management

• avoid reflux trigger foods

• small frequent meals

• thicken infants feeds

• position upright for 30 minutes

dont give prilosec or zantac

nissen fundoplication

this is a surgery that happens from recurrent complication of GERD

• surgical wrapping distal esophagus to prevent backflow

post op for nissen fundoplication

• NG

• start slow feedings

clef lip and clef palate

failure of the bone and tissue of upper jaw plate to fuse

risk for poor feeding and infection

pre op duties for clef lip/palate surgery

• slow upright feeds

• specialty nipple

• burp frequently

• small frequent feeds

post op duties for clef lip/palate surgery

• appropriate position for airway

• no straws, pacifiers, spoons, or fingers for 7-10 days

• use elbow restraints

• prevent crying

nectortizing enterocolitis s/s:

• distended gas filled intestinal loops

• rectal bleeding

• difficulty feeding

• gastric ileus (obstruction)

medical emergency

seen in premature babies